4/3/2014. Dame Cicely Sanders : Born in England Nursing Degree Social Work Degree Doctor Opened 1 st Stand Alone Hospice 1967

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1 Catherine Hausenfluke Independent Consultant Know More about Dying and Grief Come to Terms with Your Own Morality Understand Grief and What are the Rules Understand the Dying Process Relating to a Dying Person Dame Cicely Sanders : Born in England Nursing Degree Social Work Degree Doctor Opened 1 st Stand Alone Hospice 1967 What Can We Do What Not to Do or Say Hospice Came to US in 1960 s Medicare pays 100% Terminal Illness with 6 Months or Less to Live Does Not Hasten Nor Postpone Death Team Approach Volunteer Programs Medicare Mandated Happens in a variety of places Death Denying Believe Women are more Emotional than Men Believe there is Closure Believe that tears or crying is bad Death is a punishment from God Believe there is something we can do to Fix it Believe being strong is an admirable and desirable reaction to loss 1

2 Understanding your feelings about death and dying is essential in order to care and support the patient and the family. Confrontation with your own mortality is inevitable but remember when visiting with the patient, it is about THEIR needs not your needs. Grief: A natural reaction to a significant loss. We grieve when: a loved one dies; a significant relationship ends; a loved one is in a chronic or terminal illness. We also grieve when we lose something we have valued: Job; Financial Security; Possessions, Family Pet, Home Some people do, some people don t There are no rules for crying Crying is nature s way of releasing tension and expressing emotion It lets others know that you need to be comforted Chemical make up 2

3 Shock Denial Anger Bargaining Depression Acceptance Rule Number 1 Rule Number 2 Love of your parents unconditional You will love many people You will receive love Dark side of love is grief We love greatly and we mourn greatly The degree of grief is commensurate to the love relationship Two things in life that are certain: Taxes and Death You will lose people that are important to you Rule Number 3 Rule Number 3 cont Physical: Lack of Sleep Chest/Stomach Pains Overeating/Lack of Appetite Inability to Concentrate Loss of Memory Fatigue Headaches Tension Emotionally: Sadness Depression Fear Anger Tearfulness Doubt Hallucinations/Hearing Voices Regret Guilt 3

4 Rule Number 3 cont Rule Number 4 Spiritually: Affirm or adjust your religions concepts Anger at God Denial of God People will say the wrong things Friends will abandon you Comfort and understanding maybe difficult to find Your grief is YOUR grief no one else is you Rule Number 5 Rule Number 6 Why don t you just get over it? Eye rolls or other facial expressions of impatience Impatient with yourself shouldn t I be over this by now? Special occasions and the anniversaries will be difficult Slow and painful process surrender Life will always be different it will never be the same Different emotions all at the same time crashing over you Music, a smell, a sound A time of day Ignoring it will be unsuccessful Feel the sadness until it subsides Rule Number 7 Rule Number 8 Special Occasions Anniversary of the onset of the illness death Develop a plan Have a time of remembrance Crying during a season of grief releases toxins from the body and brings healing. Crying is a natural part of the healing process 4

5 Rule Number 9 Rule Number 10 Healing the wounds of the heart takes time You will grieve the loss of your loved one the rest of your life Your grief is a reflection of the love you have experienced It is a journey that will last a lifetime Experiencing the loss of a loved one Life will be good once again but it will never be the same Nzbo&feature=youtu.be Have you ever felt like the person you were with wasn t listening? How did that make you feel? Do you think in your head what your response is going to be, and only hear part of what is being said? Do you feel uncomfortable with long pauses or silence? Do the dying patients and their families deserve to have your full attention? Communication is the act of exchanging ideas, messages, thoughts, and information both verbally and non-verbally. This includes listening, talking, and body language. Patients have feelings, wishes, and opinions. They have the right to be heard, to make peace with themselves and their families, to get things in order, and to die with dignity. Every person is different!!! No two people react to life s events alike, even when they live together in a loving relationship such as a marriage and family. Accept another s personhood and space. Non-verbal communication can often speak louder than words. Watch facial expressions, body language, and eye contact. If the verbal and non-verbal are not matching up, help clarify. Listening is important!! Don t plan a rebuttal while a speaker is talking. Reflect the feeling you hear being expressed by the speaker. 5

6 Feelings are real more important, at times, than the facts! They indicate exactly what is happening in a communication. Never tell someone how they should feel. Speak as clearly as you can about an issue, not a person. Judging, critical comments do not encourage the other person to be open to you. Express affection, appreciation, and affirmation (verbally and non-verbally) as often as it s possible and real. Be at ease with silence. Stop Talking!!!! Listen to what is being said both directly and indirectly Show external signs of listening by eye contact, nodding appropriately, smiling, gestures, posture Remove distractions such as doodling, tapping or paper shuffling Concentrate Allow plenty of time and do not interrupt Observe signals that a person wants to talk such as leaning forward, seeking eye contact, stealing glances at you Don t argue either verbally or mentally Listen to how something is said Listen for what is not said and to the person s nationality, religion, experience, conditioning, and feelings Paraphrasing helps you to clarify what is being said. Repeat or rephrase what you feel is trying to be conveyed. Ask open ended questions to encourage free discussion 6

7 The advice that I would share with a Volunteer is: Volunteering is the ministry of presence. You don t have to have an agenda or activities planned for your visits to your patients, you don t have to have memorized a speech or have a doctorate in social work or counseling and certainly none of us have all the answers. Our patients conditions can change from day to day. Just go visit with an open heart and let your spirit guide you as to what to do or say (if anything). Sometimes our patients and families just need to know that they are not alone in the process of dying, they need to know another human being cares enough to spend time with them and value their lives, honor their grief, and listen to whatever needs to be expressed. One day, a small oppening appeared on a cocoon; a man sat and watched the butterfly for several hours as it struggled to force its body through that little hole. A Butterfly s Lesson 7

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